Engaging Patients in Hand Hygiene

Transcription

1 Intermountain APIC and Qualis Health present I-APIC HAI Prevention Learning Network Webinar Series Engaging Patients in Hand Hygiene June 13, 2012 Timothy Landers, CNP, PhD Engaging Patients in Hand Hygiene Timothy Landers RN CNP PhD Assistant Professor College of Nursing The Ohio State University Columbus, OH 1

2 Patient Hand Hygiene (PHH) Objectives 1. Identify current evidence for the role of patients hands in the transmission of infection. 2. Describe current efforts to include patients in hand hygiene. 3. Identify three important considerations of a patient hand hygiene program. Does your hospital have programs in place to increase patient engagement in infection control and prevention? A. Yes B. No C. Don t know 2

3 Does your hospital have programs in place to increase patient engagement in hand hygiene? A. Yes B. No C. Don t know 3

4 Evidence that patients hands could be involved in transmission of HAIs Our natural ecology Environmental contamination Direct transmission Endogenous vs. exogenous sources of infection 4

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6 Man vs. microbe Number of organisms Man Bacteria Biomass Time on earth 6

7 Evidence that patients hands could be involved in transmission of HAIs Our natural ecology Environmental contamination Direct transmission Endogenous vs. exogenous sources of infection Environment 7

8 Environment Evidence that patients hands could be involved in transmission of HAIs Our natural ecology Environmental contamination Direct transmission Endogenous vs. exogenous sources of infection 8

9 Direct Transmission Patient cases linked with higher norovirus transmssion compared to HCW staff (OR 4.8) Outbreak investigations (insert your recent outbreak here) Patients are commonly colonized Enteroocci present on hands 10.7% nonhospitalized adults 62% hospitalized patients Coliform contamination 20.4% general medical 35.8% spinal ward 9

10 48 hours after admission 39% positive 10

11 Patient Hand Hygiene (PHH) Objectives 1. Identify current evidence for the role of patients hands in the transmission of infection. Transfer of pathogens in environment Direct spread to other patients Transferring pathogens to HCW hands Increasing own risk of infection 11

12 Studies on patient hand hygiene Patients as monitors/auditors of HCW HH compliance It s ok to ask CleanYOURhands Partners in your care Model of patient-centered care 12

13 Studies on patient hand hygiene Only 50% of patients were offered HH after using commode 64% of nurses reported offering HH opportunity to patients % of patients and HCWs recognized that HH is important in preventing infection Patient Hand Hygiene (PHH) Objective 2 Review Describe current efforts to include patients in hand hygiene. Most published programs include patients as monitors/auditors of HCW HH Including patients increases HCW HH Joint Commission standards require including patients and visitors in infection prevention activities 13

14 Patient hand hygiene: The need 14

15 Patient Hand Hygiene (PHH) Components of best practice Timing Technique Product formulation Education of staff, patients, and visitors Part of a multi-modal strategy When implementing a patient hand hygiene protocol, how concerned are you about costof such a program? A. Very concerned B. Somewhat concerned C. Not concerned at all 15

16 When implementing a patient hand hygiene protocol, how concerned are you about patient ingestion of alcohol-based hand sanitizers? A. Very concerned B. Somewhat concerned C. Not concerned at all When implementing a patient hand hygiene protocol, how concerned are you about theft or shrinkageof alcohol-based hand sanitizers? A. Very concerned B. Somewhat concerned C. Not concerned at all 16

17 When implementing a patient hand hygiene protocol, how concerned are you about environmental safety issues of alcohol-based hand sanitizers? A. Very concerned B. Somewhat concerned C. Not concerned at all When implementing a patient hand hygiene protocol, how concerned are you about the development of antibiotic resistance? A. Very concerned B. Somewhat concerned C. Not concerned at all 17

18 PHH: Timing PHH: Timing After toileting When leaving and returning room Before eating, drinking, taking medicine Before invasive procedures After coughing, sneezing Before and after contact with visitors 18

19 Please provide feedback on this quote Hand hygiene: After pees, wheeze, please, leaves, or sneeze. Do you think that this rhyme would be useful in advocating for patient hand hygiene? A. Yes very useful B. Somewhat useful C. Not at all useful D. Somewhat unuseful E. Make a mockery of HH and should not be used 19

20 PHH: Technique Use of ABHR vs. soap and water Length of product use PHH: Product formulation Gels, foams Soap and water Wipes Must address patient preference and acceptance 20

21 PHH: Part of a multimodal strategy Patient and family education Monitoring and feedback Organization commitment Consideration of product placement Patient Hand Hygiene (PHH) Objective 3 Review Identify three important considerations of a patient hand hygiene program. Timing Technique Product formaultion Dispenser location Part of a bundled approach! 21

22 Patient Hand Hygiene (PHH) Objectives 1. Identify current evidence for the role of patients hands in the transmission of infection. 2. Describe current efforts to include patients in hand hygiene. 3. Identify three important considerations of a patient hand hygiene program. Contact Information Timothy Landers landers.37@osu.edu Intermountain APIC Trish Heath, Education Lead trishh@slhs.org Ginna Maggard, President ginna.maggard@hcahealthcare.com Quality Improvement Organizations Jennifer Palagi Qualis Health, Idaho QIO jenniferp@qualishealth.org Tina Schwien Qualis Health, Washington QIO tinas@qualishealth.org Laurie Murray-Snyder Acumentra Health, Oregon QIO lmurraysnyder@acumentra.org This material was prepared by Qualis Health, the Medicare Quality Improvement Organization for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. ID/WA-C7-QH

23 Save-the-Date: I-APIC HAI Series CDC s Epi-X: Spotting and Relaying Trends to Providers Wednesday, July 11, 1pm MT/12pm PT Jim Schwendinger, MSN, MPH, NP Team Lead, Epi-X & HAN Director, Epi-X & Team Lead, Epi-X and HAN Team Emergency Risk Communication Branch Division of Emergency Operations Office of Public Health Preparedness and Response Centers for Disease Control and Prevention (CDC) Preventing Central Line Infections August Date May Change 45 Presentation Evaluation Will automaticallypop-up when you close out of presentation on your computer Share the evaluation link below with others attending with you, to capture their feedback Brief Survey Monkey: